Tetanus in Childhood: Report of a Therapeutic Trial of Diazepam

Abstract

Results of therapeutic trial of diazepam in tetanus are reported. The trial included 149 patients—104 neonates and 45 older children. Patients were randomly allocated into two treatment groups, one of which received diazepam in addition to the standard treatment used in both groups. In neonatal tetanus the mortality rate was unaffected by the use of diazepam, but the drug was of value in relieving tonic muscle spasm, in particular trismus. A significant number of patients who received diazepam had minimum temperatures of 95 °F. (35° C.) and lower, but did not appear to be adversely affected by this. In older children with tetanus the overall mortality rate was lower among those who received diazepam than among those who did not, but the difference is not statistically significant. As in neonates, the drug was of value in relieving tonic spasm but did not seem to have any direct effect on convulsive spasms. Findings in this trial indicate that diazepam is a useful drug in the management of tetanus, principally because of its ability to reduce tonic muscle spasm. Its use appears to be free of toxic effects or unpleasant side-actions. In older children it may have favourably influenced mortality from the disease. © 1966, British Medical Journal Publishing Group. All rights reserved.